Defying Deprivation: Neurosurgical Outcomes and 75% Six-Month Survival in 96 Primary Brain Tumor Cases Amid Yemen's Humanitarian Crisis.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-10-06 DOI:10.1016/j.wneu.2025.124526

Marwan Yahya Mohammed Al-Asadi

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引用次数: 0

Abstract

Background: Yemen's protracted humanitarian crisis has devastated healthcare infrastructure, creating profound challenges for the management of primary brain tumors under severe resource constraints. This study characterizes patient profiles, surgical approaches, and six-month outcomes at a tertiary neurosurgical center in Sana'a (2023-2024).

Methods: A retrospective cohort of 96 consecutive patients undergoing surgery for primary brain tumors was analyzed. Data extraction included demographics, clinical presentation, imaging findings, tumor location and histopathology (WHO CNS5, 2021 classification), extent of resection, complications, adjuvant therapies, and six-month survival status. Statistical analyses employed chi-square tests, Kaplan-Meier survival estimates, and Cox proportional hazards regression.

Results: The median patient age was 35 years (range 0.5-80), and 60.4% were male. Supratentorial tumors (78%) were most common, with meningioma (19.8%) and glioblastoma (14.6%) representing the predominant histologies. Gross total resection (GTR) was achieved in 61.5% of cases. The overall complication rate was 28%, including cerebrospinal fluid leak (7%) and surgical site infection (5%). Adjuvant therapy was received by 38.5% of patients. The overall six-month survival rate was 75%. Survival was significantly superior in GTR compared to STR or biopsy (83.0% vs. 65.6%, p=0.01) and in those with WHO Grade I-II tumors compared to Grade III-IV tumors (94.4% vs. 51.5%, p<0.001).

Conclusion: Despite operating amidst chronic power outages and critical supply shortages, the implementation of strategic adaptive protocols enabled the achievement of neurosurgical outcomes comparable to those reported in other low-resource settings. Prioritizing reliable imaging, minimizing complications, and improving access to adjuvant therapies are crucial for further improving prognosis for brain tumor patients in Yemen.

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无视剥夺：也门人道主义危机中96例原发性脑肿瘤患者的神经外科手术结果和75%的六个月生存率。

背景：也门旷日持久的人道主义危机摧毁了卫生保健基础设施，在资源严重紧张的情况下，对原发性脑肿瘤的管理构成了深刻的挑战。本研究描述了萨那三级神经外科中心的患者概况、手术方式和六个月的预后（2023-2024年）。方法：对96例连续手术治疗原发性脑肿瘤患者进行回顾性队列分析。数据提取包括人口统计学、临床表现、影像学表现、肿瘤位置和组织病理学（WHO CNS5, 2021分类）、切除程度、并发症、辅助治疗和6个月生存状态。统计分析采用卡方检验、Kaplan-Meier生存估计和Cox比例风险回归。结果：患者中位年龄为35岁（0.5-80岁），60.4%为男性。幕上肿瘤（78%）最为常见，以脑膜瘤（19.8%）和胶质母细胞瘤（14.6%）为主要组织学。总切除（GTR）率为61.5%。总并发症发生率为28%，包括脑脊液漏（7%）和手术部位感染（5%）。38.5%的患者接受辅助治疗。总6个月生存率为75%。GTR的生存率明显优于STR或活检（83.0% vs. 65.6%, p=0.01）， WHO I-II级肿瘤的生存率明显优于III-IV级肿瘤的生存率（94.4% vs. 51.5%）。结论：尽管在长期停电和严重供应短缺的情况下进行手术，但实施战略适应性方案能够实现与其他低资源环境下报道的神经外科结果相当的结果。优先考虑可靠的影像、尽量减少并发症和改善辅助治疗的可及性对于进一步改善也门脑肿瘤患者的预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS